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Biomedical subjects

N Thomas

Publications and source records attributed to N Thomas.

214 records · Page 12Linked to original sources
PubMedDate not supplied

Pain control: patient and staff perceptions of PCA.

In the United Kingdom, patient controlled analgesia (PCA) has been used primarily as a research tool and its place in the treatment of postoperative pain is only slowly being established. The concept of patients being able to control their own pain relief is therefore new to staff and patients. In this study, a small part of a larger study concerned with the personality characteristics and the effectiveness of PCA which formed the basis of the author's PhD research, 70 patients who had used PCA for postoperative pain relief, and 20 nursing and anaesthetic staff, completed a questionnaire about PCA. The results showed a high level of enthusiasm for PCA among all categories of respondents.

Analgesia, Patient-Controlled↗
PubMedDate not supplied

Pregnancy in a patient with hypopituitarism following surgery and radiation for a pituitary adenoma.

This is a case of partial hypopituitarism resulting from surgery and radiation for a non- functioning pituitary macroadenoma. The patient had amenorrhea which was secondary to hypogonadotrophic hypogonadism and had been on L-thyroxine for central hypothyroidism. For pregnancy, ovulation was induced by gonadotrophins and this was followed by an intrauterine insemination. The antenatal period was uneventful and a Caesarean section was done at 33 weeks when the patient presented with preterm labour. Both infant and mother are well, eight months after delivery.

Adenoma↗
PubMedDate not supplied

Interpreting hospital mortality data. The role of clinical risk adjustment.

This study uses national Medicare data as well as data that were abstracted to calibrate the Medicare Mortality Predictor System to assess the usefulness of a risk adjustment system in interpreting hospital mortality rates. The majority of variation in annual hospital death rates for the four conditions studied (stroke, pneumonia, myocardial infarction, and congestive heart failure) is chance variability that results from the relatively small numbers of patients treated in most hospitals in a year. For hospitals in the highest and lowest quartiles of observed death rates, the difference between observed rates and those predicted by the Medicare Mortality Predictor System is not quite on third smaller than the difference between observed rates and unadjusted national rates. Risk adjustment methods do not show whether the unexplained difference in mortality rates results from differences in effectiveness of care or unmeasured differences in patient risk at the time of admission. Risk-adjusted mortality rates, therefore, should be supplemented by review of the actual care rendered before conclusions are drawn regarding effectiveness of care.

Aged↗
PubMedDate not supplied

Aetiology of hyperkalaemia in hospital inpatients.

BACKGROUND: Hyperkalaemia is a common metabolic disorder; if left untreated it can lead to life-threatening consequences. We conducted this study to determine the common aetiological factors for hyperkalaemia in hospital inpatients. METHODS: This prospective cross-sectional study was conducted in a referral teaching hospital in south India. One hundred and forty-three patients with hyperkalaemia (> 5 mEq/L) were selected on 20 random week days over a 3-month period. All the patients were clinically and biochemically evaluated for the aetiology of hyperkalaemia. RESULTS: Hyperkalaemia was twice as common amongst males. Potassium supplementation and drugs were the leading causes for hyperkalaemia, with renal failure being a distant second. Hyperkalaemia developed after admission to hospital in more than 75% of the patients. Severe hyperkalaemia (> 6 mEq/L) was seen in one-third of the patients. CONCLUSION: Potassium supplementation and other iatrogenic conditions lead to hyperkalaemia in inpatients. Males are at increased risk for hyperkalaemia.

Adolescent↗
PubMedDate not supplied

Evaluation of the hypothalamo-pituitary-adrenal axis: the insulin tolerance test and beyond.

Assessment of the hypothalamo-pituitary-adrenal axis is essential to determine the strength of the adrenocorticotrophic hormone (ACTH) reserve in relation to clinical and subclinical hypocortisolaemia. The insulin tolerance test has been established as the gold standard; however, the time and the potential hazards involved have led to a search for more viable alternatives. Numerous tests have evolved, which include the 8 a.m. fasting plasma cortisol, standard short synacthen test, low dose (1 microgram) synacthen test, metyrapone provocation and glucagon stimulation test. The low-dose (1 microgram) synacthen stimulation test has emerged as a potential alternative but further well designed trials are required to establish this.

Adrenal Cortex Function Tests↗